Enlarged Prostate: A Complex Problem
There are many treatments for enlarged prostates (BPH), but all have side effects and possible complications. Learn what to expect -- and how to decide.
Deciding on Treatment for an Enlarged Prostate
A range of treatments can relieve enlarged prostate symptoms -- medications, minimally-invasive office procedures, and surgery. The best one for you depends on your symptoms, how severe they are, and whether you have other medical conditions.
The size of your prostate gland, your age, and your overall health will also factor into treatment decisions. What's best for a man in his 50s might not be optimal for an 80-year-old. An older man may want immediate symptom relief through drugs or surgery, whereas a younger man may lean toward a minimally invasive treatment. According to the American Urological Association, surgery often does the best job of relieving symptoms, but it also has more risks than other treatments.
Consider the options carefully with your doctor, says Westney. "We can start with medications, and if there's no improvement, we look at minimally invasive therapy to reduce a portion of the prostate," she tells WebMD. "These procedures are very effective, and side effects are very rare."
If symptoms are really bothersome -- or if you have complications like urine retention -- it may be best to bypass medication. The minimally invasive treatments have benefits over surgery, like quick recovery time; however, you may need a second procedure later on. There is also less risk of serious side effects like long-term incontinence or erection problems -- which can occur rarely with surgery.
Medications for an Enlarged Prostate
Several drugs are FDA-approved to relieve common symptoms of an enlarged prostate. Each works differently, says Westney. They either shrink the enlarged prostate or stop the prostate cell growth, she explains. "For many men, medications are very effective," Westney tells WebMD. "They have a significant change in symptoms, and side effects are very uncommon … so medications are an attractive treatment."
Doctors use the BPH Index to gauge how the patient responds to medication, Westney adds. "We see how symptoms are progressing … if they've stabilized or not."
Alpha blockers: These drugs don't reduce the size of the prostate, but they are very effective at relieving symptoms. They work by relaxing the muscles around the prostate and bladder neck, so urine can flow more easily. These drugs work quickly, so symptoms improve within a day or two. They are most effective for men with normal to moderately enlarged prostate glands.